Organization
MAGNOLIA GARDENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH YARBROUGH (OWNER)
(336) 983-7635
Entity
Organization
Contact information
Practice address
594 MURRAY HILL RD, SOUTHERN PINES, NC 28387
(910) 692-6311
Mailing address
594 MURRAY HILL RD, SOUTHERN PINES, NC 28387-7016
(910) 692-6311
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-063-007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7802822
MEDICAID PROVIDER NUMBER
NC
Enumeration date
09/06/2007
Last updated
09/06/2007
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